Résumés
Abstract
Caring for persons living with dementia (PLWD) is challenging. Some of the most challenging aspects include managing behavioral and psychologic symptoms of dementia (BPSD). Many patients and families will consider dementia care facilities to better manage BPSD, which can contain design elements that use the physical environment to decrease BPSD by deceiving residents and controlling their behavior—all for their own benefit and safety. This immersive approach to behavior management represents a more holistic way to manage BPSD. Considering the especially vulnerable status of PLWD, these design elements should be thoughtfully implemented, researched post-implementation, and discussed with patients and their loved ones. The design-based approach to managing BPSD demonstrates the obligation healthcare providers and facility designers have to be more holistic in designing care environments for PLWD, especially for those living in dementia care facilities.
Keywords:
- Bioethics,
- Dementia,
- Architecture,
- Deception,
- Ethics,
- Architecture design
Veuillez télécharger l’article en PDF pour le lire.
Télécharger
Parties annexes
Bibliography
- Cerejeira J, Lagarto L, Mukaetova-Ladinska EB. Behavioral and psychological symptoms of dementia. Front Neurol. 2012;3:73.
- Kincaid C, Peacock JR. The Effect of a Wall Mural on Decreasing Four Types of Door-Testing Behaviors. J Appl Gerontol. 2003;22(1):76–88.
- Hussian RA, Brown DC. Use of two-dimensional grid patterns to limit hazardous ambulation in demented patients. J Gerontol. 1987 Sep;42(5):558–60.
- Klosterman C. The New York Times [Internet]. 2024 [cited 2023 Apr 22]. Nursing-home pitfalls. Available from: https://www.nytimes.com/2014/03/02/magazine/nursing-home-pitfalls.html?ref=theethicist&_r=0.
- Dickinson JI, McLain-Kark J. Wandering behavior and attempted exits among residents diagnosed with dementia-related illnesses: a qualitative approach. J Women Aging. 1998;10(2):23–34.
- MacFarquhar L. The New Yorker [Internet]. 2018 [cited 2023 Apr 22]. The comforting fictions of dementia care. Available from: https://www.newyorker.com/magazine/2018/10/08/the-comforting-fictions-of-dementia-care.
- Dementia Village Associates. De Hogeweyk [Internet]. [cited 2023 Apr 22]. Available from: https://www.dementiavillage.com/projects/dva-de-hogeweyk/.
- Anderson DC, Teti SL, Hercules WJ, Deemer DA. The Bioethics of Built Space: Health Care Architecture as a Medical Intervention. Hastings Cent Rep. 2022 Mar;52(2):32–40.
- Madhusoodanan S, Ting MB. Pharmacological management of behavioral symptoms associated with dementia. World J Psychiatry. 2014 Dec 22;4(4):72–9.
- Chan TE. Regulating the placebo effect in clinical practice. Med Law Rev. 2015;23(1):1–26.
- Blumenthal-Barby JS, Burroughs H. Seeking better health care outcomes: the ethics of using the “nudge.” Am J Bioeth AJOB. 2012;12(2):1–10.
- Alzheimer’s Society. ‘I want to go home’ - What to say to someone with dementia in care [Internet]. 2023 [cited 2023 Apr 22]. Available from: https://www.alzheimers.org.uk/blog/i-want-go-home-what-to-say-to-someone-in-dementia-care
- Woods S. Respect for persons, autonomy and palliative care. Med Health Care Philos. 2005;8(2):243–53.
- Dresser R. The Limited Value of Dementia-Specific Advance Directives. Hastings Cent Rep. 2021 Mar;51(2):4–5.
- Fellows LK. Competency and consent in dementia. J Am Geriatr Soc. 1998 Jul;46(7):922–6.
- Digital Synopsis. Elderly People Look at Their Younger Reflections in this Beautiful Photo Series by Tom Hussey [Internet]. [cited 2023 Apr 22]. Available from: https://digitalsynopsis.com/design/reflections-of-the-past-tom-hussey/.
- Kelsick JR, Freysteinson WM. Who is that stranger in the mirror? The mirror experience for elderly patients with dementia. Holist Nurs Pract. 2013;27(5):268–72.
- Deemer DA, Peavey EK, Teti SL, Hercules WJ, Wong J, Anderson DC. How Should Organizations Be Held Accountable for Promoting Environments That Foster Social Connection? AMA J Ethics. 2023 Nov 1;25(11):E825-832.